A diagnosis of end-stage kidney disease means that you are in the final stage of kidney disease, and your kidneys are not functioning well enough to meet the needs of daily life. Your kidneys are responsible for filtering waste and excess water from the blood in the form of urine.

If you have end-stage kidney disease, also referred to as end-stage renal disease (ESRD), your kidneys are functioning below 10 percent of their normal function. This may mean that your kidneys are barely functioning or not functioning at all. Kidney disease is usually progressive. It typically does not reach the end stage until 10 to 20 years after you are diagnosed with chronic kidney disease, which may also develop slowly.

Many types of kidney diseases attack the nephrons—the tiny units in the kidneys that actually do the filtering. The result is blood not being filtered properly and, eventually, ESRD. Diabetes and hypertension (high blood pressure) are the two most common causes of ESRD. Diabetics cannot break down glucose (sugar) correctly, and levels remain high in the blood. High levels of glucose in the blood damage the glomeruli in the nephrons. If you have hypertension, the increased pressure that is forced upon the small vessels in the kidneys leads to damage that makes the vessels unable to perform their blood-filtering duties.